PCOS and Every Question You Had About It

If you are reading this article, it is safe to guess that you have just made acquaintance with PCOS, Polycystic Ovary Syndrome. Sounds scary, doesn’t it? Perhaps, you got diagnosed or someone you know did, and as is with everything today, this too can be googled.

I remember when I was first diagnosed with PCOS. I had been lazy with my workout and hyperactive with binge-watching and eating, for months. It all had to show somewhere and it finally did, when one fine Monday, periods were painful, heavy, and emotionally exhausting. When it didn’t ease down on me after 10 days of constant bleeding, I knew something was wrong.

What followed was a diagnosis, a realization that I was 10kgs overweight, and that I have to go on oral contraceptives to fix this??  None of it made sense. I remember googling anxiously to find the help I was looking for, “What is PCOS?”, “How to fix PCOS?”, but, even after days of Google escapades, I only found articles that petrified me. They told me PCOS meant infertility, one step closer to cardiac problems, and overall a whack reproductive system. 

So, when I sat down with Dr. Liston, my first question was,

“How do we describe PCOS to someone who just got diagnosed and is freaking out?”

Women menstruate when the uterine wall has to be shed. The uterine wall exists to provide support, nourishment, and nutrition to a fertilized egg. In the event that the egg isn’t fertilized, the uterine wall will self-destruct, but what if the egg isn’t there, to begin with? 

PCOS is a condition when a woman’s ovaries have eggs but the follicles that hold these eggs do not release them periodically. This release is called ovulation. An egg that isn’t released can also not be fertilized. 

In PCOS, the eggs are not released regularly. The uterine wall doesn’t form regularly and so it doesn’t break regularly either. After your last period, your body will be on a hormonal low for 14 days. Estrogen comes into play here. Estrogen has to increase naturally and select the follicles which will bear the eggs and release them for the next month. So, if your estrogen is working fine, you have to then look at Follicle-Stimulating Hormone or FSH, which would develop the follicles. Once the follicles are developed, you have sacs full of eggs. Now comes, the Luteinizing Hormone or LH, which is responsible for the release of the egg from the follicle.

After 14 days, your progesterone takes over and it is now responsible to provide for a fertilized egg. Progesterone has to make sure the egg has plenty of blood circulation and an inner wall to cling on. However, if the egg isn’t fertilized both estrogen and progesterone have to fall. This is when you get periods and as the uterine wall breaks, all the excess hormone too gets out of the system. 

The cycle repeats.                                             It looks pretty simple, but any slight fluctuation in these hormone levels and your periods can be disrupted, which is exactly what happens in PCOS.

But, just because you’re late, it doesn’t mean PCOS!

The follicle or sac that holds these eggs grows to an abnormal proportion and has the appearance of a cyst, hence the name – polycystic. However, it isn’t really a cyst, as Dr.Liston would tell us later in this article. When these eggs aren’t released on time, other activities that follow post ovulation also take a setback, menstrual activity being one. 

This leads to irregular periods, scarce or excessive uterine shedding, spotting, and hormonal disbalance in a woman’s body. 

PCOS is more common in women at the peak of their reproductive health. It isn’t very common in women passing through menarche because that is the start of menstruation, a time when hormones aren’t regulated and it’s normal to have irregular periods. That is, in most cases, not PCOS. 

The same goes for menopause. Between 18-35 is when most women are diagnosed with PCOS. 

Not sure what’s causing your delay? Get in touch with our  team of doctors who would help you find the right answers.
 Click here for a FREE CONSULTATION 

“Is PCOS the same as PCOD?”

There are two schools of thought here! The first one states that PCOD and PCOS are synonyms, and in a way that isn’t wrong. However, PCOD is Polycystic Ovary Disorder which is an ovarian dysfunction. PCOS is a syndrome and can be of 3 types: 

• Polycystic ovaries: Where the follicles grow to abnormal proportion.
• Hyperandrogenism: A higher amount of male hormones (testosterone)  
• Endocrine dysfunction: Complete inability to mature eggs

In simple words, PCOD is a disorder that you develop because of hormonal imbalance, however, PCOS is a more severe and multi-faceted PCOS, with more symptoms. 

What causes PCOS? 

This was naturally my next question. 

“To be absolutely honest, PCOS can’t be pinned to one particular cause.”, said Dr.Liston. “We have found that women with a sedentary lifestyle (being inactive), poor sleep, unhealthy diet, are more prone to PCOS. However, there are women with all of that who have none of the symptoms.” 

It sure is like opening a can of worms when you diagnose someone with PCOS.

This reminds me, doctor! “How do we diagnose PCOS?”

The diagnosis itself doesn’t have pre-laid tests. 

Your gynaecologist would ask you about your last menses and how had the bleeding, the pain, or the frequency been. They may recommend a few blood tests to understand your sugar and hormone levels better, which helps doctors rule out other ovarian conditions. 

In the case of PCOS, the symptoms are the diagnosis. 

If you too have been experiencing these symptoms and are unsure what to do next, click here to book your FREE CONSULTATION today. 

Though we may not be able to narrow down the causes of this medical condition, we can accurately map out the symptoms, which are as follows:

• Menstrual discomfort: Heavy or lighter than usual bleeding, irregular cycle, pain, discomfort
• Acne, sudden growth in facial and body hair caused by excessive male hormones
• Severe mood swings and PMS symptoms
• Hair fall, bald patches, pre-mature greying
• Fluctuating sugar levels and insulin resistance: 70-80% of women suffering from PCOS exhibit signs of pre-diabetes and high sugar. They may experience fatigue even after having proper meals or they may crave more sugar and fat. This could be due to insulin resistance and so, PCOS may lead to excessive weight gain and hence, diabetes later in life, another issue that comes with obesity.
• Difficulty losing weight and if lost, it’s hard to maintain the weight at healthy levels
• In the case of slim PCOS, it gets difficult to gain weight
• The biggest symptom, however, is the difficulty to conceive. 

Most women only find out they have been suffering from PCOS when they are unable to conceive after multiple attempts. However, at this point, the condition has probably worsened and is more difficult to recover from. Thus, an early diagnosis and caution would save you discomfort in the future. This is why, you should consider speaking to an expert today.

“Does PCOS mean infertility?”

Not at all, says Dr.Liston reassuringly. “PCOS makes it hard to predict and plan pregnancy because, for a healthy ovarian function, ovulation happens almost half a month after your periods. However, in the case of PCOS, ovulation isn’t regular and can’t be predicted.”

 This means you would have more difficulty planning your pregnancy, but, this, in no way, means that you can’t get pregnant. Your ovaries still do have eggs, which can mature and they do! And every menstrual cycle that they do finally mature, you have your periods. Thus, PCOS only in severe cases, when ovaries no longer release eggs, is infertility. 

In most cases, women with PCOS go on to conceive and have completely normal pregnancies. 

“The unpredictability too can be solved using ovulation drugs.”, and this reminded me of my own confusion with PCOS. When I was diagnosed, I was immediately told that popping contraceptive pills was the solution, which didn’t sit right with me since we have grown up reading about their side-effects. 

Is it wise to use oral contraceptive pills for PCOS?

“Unless you don’t have any other options, I wouldn’t recommend it.”, says Dr. Liston. “It is always wise to look at a patient and try to understand their body specifically. I always start with diet plans and encourage them to exercise regularly. Particularly exercises like brisk walks and jogs that are known to directly encourage ovarian functions!”

Most doctors, however, would immediately prescribe you oral contraceptives.                                                    

Being the hypochondriac that I am, I googled all of my pills and found out the long list of cons. 

However, that being said, there is a reason why they are prescribed. “These are hormones essentially.”, Dr.Liston explains. “You are ingesting hormones with those pills. You have to continue this medication only till your cycle is back to set. No doctor would put you on continuous medication for PCOS. Once your cycle is back on track, your only job is to adopt a healthy lifestyle and maintain it. Plus, short-term usage of these pills does not have any significant side effects. Prolonged use is another story.”

Patients with a familial history of cardiac problems or diabetes should consult their doctor before commencing with ovulation drugs. 

“Is PCOS genetic?”

PCOS is a lifestyle disorder, and though, a genetic factor is always considered, there are chances that a woman with a familial history of several generations with PCOS may never manifest it nonetheless. 

PCOS has an external trigger. 

A proper diet, sleep cycle, and physical activity would keep it at bay. 

“How late is too late to be called PCOS?”

All bodies are different. For some people, a healthy cycle maybe 30 days, and for some, it may be 26. 

“We have even seen women who have periods every 40 days and they are fine. No problems.”, says Dr. Liston, “We can be myopic in medical ways, we have to understand human bodies are complex”. 

A good rule of thumb is to +  8 days from 28 days, meaning if your periods have a gap of at least 20 days and at max 36, you probably don’t have PCOS. It is impractical to expect our bodies to always be on time and arrive sharply on the 28^th of each reproductive month. 

This being said, if you have always had a certain gap, say 28 days, and suddenly, it has become 20, consult a gynaecologist. While this may not be PCOS, this may hint at hormonal changes. 

One should always track the difference between two cycles, and before panicking, go through your periodic data for the last 6 cycles. 

“Does PCOS mean cysts?”

“No, I know the naming is confusing. Those aren’t cysts, but over-grown egg bags, if you will.” Dr. Liston continues, “ Cysts are different. They are usually fluid-filled membranes and painful. PCOS is just an over-grown egg bag. I do believe PCOS is getting more than its weight. Awareness is good, but it is starting to petrify young women, and I tell them it’s completely reversible. In fact, getting stressed out is the worst thing you could do in PCOS and throw your hormones further down the pit”. 

“How do we reverse PCOS then?”

We could start with addressing the fact that it’s a disorder and not a disease. As is with any lifestyle disorder, we have to make the following lifestyle changes: 

• Diet:
  This comes first, even before exercise, because your body is 80% made in the kitchen and only 20 in the gym. Because PCOS is triggered by obesity, we have to limit carbs. This means replacing it with fiber and protein. However, in this context, fasting or starving isn’t the answer. That will further irregulate your sugar. Be mindful of what you eat, but do eat!                                                  
• Improve the way you eat: 
  Dietary changes don’t only come into the picture to help with a weight situation, but also skin conditions, which are aggravated in inflammatory PCOS. Thus, excessive sugar, alcohol, and dairy products are to be avoided for women suffering from acne, hair fall, and inflammation. Moreover, if stomach pain and digestive symptoms, too, persist, one should only limit dairy to buttermilk or curd, since they have helpful enzymes and low carbs, which aid digestion. 
   
•  Adequate sleep is very important: 
  Melatonin is a hormone that our bodies produce at night, and so, in the dark hours, it becomes important to take a nap. Serotonin, an important mood-regulating hormone, is directly linked with your sleep quality. Sleeping on time is just as important as sleeping enough. Melatonin can help regulate your stress levels, which can aid in progesterone regulation. During PCOS, mental health can be an exhausting affair for women already suffering from depression, anxiety, bipolar, or OCD, among other mental disorders. 
   
• Exercise: 
  “Walking is the answer to all your problems”, as Socrates himself put it. Brisk walks, swimming, cycling, and yoga are all low-intensity exercises that can help. Moderate exercises with a dedicated regularity work best. You only have to do 150 minutes a week, and it could be as little as 15 minutes a day at the start.
   
• Micro-nutrients:
                                                            Cooked food is half nutrients burned. Moreover, our lifestyles have left us relying on junk food, which doesn’t have any qualitative value to offer. This is why micro-nutrient supplements and nutraceutical products become important. 
  
  At Kindly Health, we are collating scientifically advanced formulas that help men and women All our offerings have been sustainably sourced and third-party tested for no side-effects.

  Tired of painful periods? Try this Pain-less period supplement today for a happy and pain free period. It is packed with            micronutrients that reduce menstrual discomfort. Get rid the discomfort and inconvenience of an irregular period with Period flow regulator which regulates your menstrual cycle safely and effectively! Start your journey towards a healthy sexual and reproductive system today. 

What’s your advice to anyone suffering from PCOS, doctor?

“Just know that it is over-diagnosed and completely overcome-able.”, Dr.Liston concludes, before turning to me, “Is overcome-able a word, ah, you’re the writer, Akanksha, I would let you decide. But, I sure hope that you and other women who have ever suffered from PCOS, consult a doctor who can help them fight it without fear. ”